CARDIOVASCULAR and

RESPIRATORY SYSTEM
CARDIOVASCULAR
SYSTEM
the heart is a muscular pump that
generates the forces that move blood
through the blood vessels.
FUNCTIONS
The following are the functions of the heart:
1. Generating blood pressure. Contractions of the
heart generate blood pressure, which is
responsible for moving blood through the blood
vessels.
2. Routing blood. The heart separates the
pulmonary and systemic circulations and ensures
that the blood flowing to the tissues has adequate
levels of O2.
3. Ensuring one-way blood flow. The valves of the
heart ensure a one-way flow of blood through the
heart and blood vessels.
4. Regulating blood supply. The rate and force of
heart contractions change to meet the metabolic
needs of the tissues, which vary depending on
such conditions as rest, exercise, and changes in
body position.
Functional Organization of the Cardiovascular System

o Pulmonary Circuit
• Gas exchange with lungs
• O2 loading, CO2 unloading

o Systemic Circuit
• Gas exchange with the rest of the body
• CO2 loading, O2 unloading
THE HEART AND
PERICARDIUM
PART ONE
Heart
o Blunt cone about the size of a closed fist
o Located in the inferior mediastinum enclosed by the
pericardium
• Base: 3rd costal cartilage ½” to the (L)
• Apex: 5th ICS, midclavicular line
o Note the orientation of the heart with the base directed post &
sup, apex directed inf, ant & towards the (L), and rotated on the Y
axis, so that the ® side lies more anterior
Note mediastinum
as the midline of
the thoracic
cavity, divided into
sup & inf by the
line from sternal
angle to T5..
Pericardium
o Fibroserous sac enclosing the heart & great vessels
o Posterior to sternum, 2nd to 6th CC (T5 to T8)
Pericardium
o Fibrous Pericardium
o Serous
• Parietal
• Visceral
(Epicardium)

** pericardial fluid
Surface Anatomy of the Heart
o Auricles
o Atrioventricular Groove
• Coronary sulcus
o Interventricular Groove
• Anterior & posterior
Note atriventricular groove that separates the
atrium from ventricles, interventricular groove to
separate the ventricles à all embedded with fat!
Surfaces of the Heart
o Sternocostal Surface
• ® atrium & ventricle
o Diaphragmatic Surface
• ® & (L) ventricles, ® atrium
Sternocostal surface --- note ® atrium, ventricle, atriovent groove & ant
intervent groove
Diaphrag surface: note 2 ventricles, post intervent groove, coronary sulcus, IVC
Surfaces of the Heart

o Base (posterior surface)

• (L) atrium
o Apex
• (L) ventricle
Borders of the Heart
• ® border • Inferior border
• (R) atrium • ® ventricle
• (L) border • Superior Border
• (L) auricle, (L) • Great vessels
ventricle
Layers of the Heart Wall
o Epicardium
• Mesothelium, loose CT
o Myocardium
• Cardiac mm, BV &
Nerves
o Endocardium
• Simple squamous
 The ® atrium
• Sulcus terminalis & crista • Openings:
terminalis • SVC & IVC

• Musculi pectinati • Coronary Sinus

• Interatrial Septum • Fossa Ovalis

• ® AV orifice

IVC – trunk & LE; SVC – head & UE • Tricuspid valve

The ® ventricle
• Trabeculae Carneae • Openings:
• Papillary muscles • ® atrioventricular

• 3 chordae tendinae orifice

• Moderator band • Pulmonary orifice

• Pulmonary valve
• Interventricular Septum
• Infundibulum (conus
arteriosus à Martini)
The (L) atrium
o Forms base of the heart
o Openings:
• From 4 pulmonary veins
• (L) atrioventricular orifice
• With mitral valve
The (L) ventricle
• Trabeculae Carneae: • Openings
• 2 papillary muscles • (L) atrioventricular
• 2 chordae tendinae orifice
• (-) moderator band • Aortic orifice
• Aortic valve
• Aortic sinuses
 (R) & (L) ventricles

Feature (R) (L)

Wall thickness Thinner Thicker
Intraventricular Lower 7x Higher
Pressure
Trabeculae (+) MB (-) MB
Carneae 3 papillary mm 3 papillary mm
3 chordae 3 chordae
tendinae tendinae
Cross Section Crescent Circular
Blood Deoxygenated Oxygenated
Valves of the Heart
• Atrioventricular • Semilunar
• (R), Tricuspid • Pulmonary
• (L), Bicuspid, Mitral • Aortic
When the heart is relaxed,
AV valves open, semilunar
closed
During contraction, AV
valves closed, semilunar
open
Route of Blood in the Heart

SVC, IVC (L) atrium (L) AV valve

® atrium Pulmonary (L) ventricle

Vein
® AV valve Aortic valve
Lungs
® ventricle
Aorta
Pulmonary Pulmonary
valve Artery
Blood Supply to the Heart

(R) Coronary
Artery

Posterior
Marginal Interventricular

RCA = ® atrium portions of (B) ventricles, SA & AV node

Marginal arteries = ® ventricles
Post descending (interventricular) = IV septum, both ventricles (post wall)
Blood Supply to the Heart

(L) Coronary
Artery

Anterior
Circumflex Interventricular
LCA = (L) atrium, (L) ventricle, interventricular
septum
Circumflex = (L) atrium
Ant descending (IV) = both ventricles (ant wall)
Venous Drainage of the Heart

Artery Vein
LADCA Great Cardiac
Circumflex Posterior Cardiac
Posterior Middle Cardiac
Descending
Marginal Small Cardiac
Conducting System of the Heart
o Sinoatrial Node
o Atrioventricular Node
o Atrioventricular Bundle of His
o Purkinje Fibers
Conducting System of the Heart
Fibrous Skeleton of the Heart

o 4 dense bands of
tough elastic tissue
o Stabilize positions of
the heart valves
o Isolate ventricles
from atria
Cardiac Muscle Tissue

Cardiac Skeletal

Size smaller larger

Nuclei Mononucleated Multiple Nuclei

Mitochondria Numerous Relatively few

Contractions Twitch Tetanic

Shape Branching Spindle shaped

PERIPHERAL BLOOD
VESSELS
PART TWO
The blood vessel wall
o Tunica intima (interna)
• Endothelial lining
• Connective tissue with elastic fibers
o Tunica media
• Concentric layer of smooth muscles
o Tunica adventitia (externa)
• Collagen & elastic fibers
Arteries

o Carry oxygenated blood

o Thick muscular walls
• Elastic & contractile
• Varying diameters in response to BP chages
• Vasodilation & vasoconstriction
Capillaries

o Endothelial tube inside a basal lamina

o Only blood vessels that permit exchange between blood &
surrounding interstitial fluid
o Slow blood flow
Capillary Network
(notes)

o Note that capillaries work as part of a network; note

importance of collateral vasculature to ensure blood flow
even with obstruction. Also stress the importance of
precapillary sphincter
Veins

o Carry deoxygenated blood from

tissues to be returned to heart
o Lower BP with larger diameters
o Valves permit unidirectional flow
 Arteries Veins

Walls Thick thin

Thickest tunic T. Media T. Adventitia

(Layer)
Cross-Section Smaller, thrown Large, collapses
into folds

Others Resists (+) valves

distortion with
high BP
 BARORECEPTORS
• REGULATES BLOOD
PRESSURE
Baroreceptors measure blood pressure by
detecting the degree of stretch of blood
vessel walls, thereby regulating blood
pressure and lead to changes in heart rate
and force of contraction.

They contain stretch receptors and are

found in the walls of large arteries (such as
internal carotid and aorta)
 CHEMORECEPTORS
• REGULATES HEART ACTIVITY
A drop in blood pH, which is often due to a rise in CO2
decrease parasympathetic and increase sympathetic
stimulation of the heart, resulting in increased heart rate and
force of contraction
Chemoreceptors measure blood pH, O2 and CO2 levels and
lead to changes in the heart rate and force of contraction.

EFFECT OF O2 IN BLOOD VESSELS:

reduction in blood O2 results in decreased heart rate and
increased vasoconstriction.
EFFECT OF CO2 IN BLOOD:
Rise in CO2 causes blood pH to drop, leading to an increased
heart rate and force of contraction
 REFLEXES THAT HELP REGULATE ACTIVITY OF HEART
BARORECEPTORS VS CHEMORECEPTORS
BARORECEPTORS CHEMORECEPTORS

Changes in blood pH and CO2 levels

MEASURES blood pressure changes
**but primarily sensitive to O2 levels
In the walls of large arteries Near large arteries close to the brain and heart:
LOCATION
1. Carotid arteries (sinus) 1. Carotid bodies
2. Aortic Arch (sinus) 2. Aortic bodies

Changes in blood pH levels or These reflexes can

Changes in blood O2 only protect the
DETECTION Stretching of the blood vessel wall reduction in blood O2 results in decreased heart rate heart for a short
and increased vasoconstriction. The vasoconstriction period
causes blood pressure to rise, which promotes blood
delivery despite the decrease in heart rate.

Changes in heart rate and force of contraction

RESPONSE
Changes in heart rate and force of If low blood o2 --> slows the heart rate, thereby
contraction reducing its need for O2
2.RESPIRATORY
SYSTEM
The respiratory system consists of the structures used to acquire
oxygen (O2) and remove carbon dioxide (CO2) from the blood.

Oxygen is required for the body’s cells to synthesize the chemical

energy molecule, ATP.
Carbon dioxide is a by-product of ATP production and must be removed from
the blood.
Otherwise, increased levels of CO2 will lower the pH of the blood. The blood pH
must be maintained within relatively narrow limits to maintain homeostasis
There are two broad aspects of respiration:
1. Ventilation
2. Respiration Pulmonary respiration

Systemic Respiration
 Functional Division of
Structural Division of the
the Respiratory system
Respiratory system
Conducting Zone. These are parts of the
respiratory system exclusively for air
Upper Respiratory Tract. This movement. This extends from the nose to
includes the external nose, nasal the bronchioles.
cavity, the pharynx with its Respiratory Zone. This takes place within
associated structures, and the larynx. the lungs and is where gas exchange
Lower Respiratory Tract. It includes between air and blood takes place. It
the trachea, the bronchi, the begins as the terminal bronchioles feed
bronchioles, and the lungs. into respiratory bronchioles within the lung.
Protruding from these smallest bronchioles
are scattered alveoli.
Upper Respiratory tracy:
Nasal cavity and Pharynx
Upper Respiratory tracy:
Pharynx
Connects the nasal cavity and mouth superiorly to the
larynx.
Serves as passageway for both air and food*
Divided into three regions:
1. Nasopharynx
2. Oropharnyx
3. Laryngopharynx
LARYNX
 PAIRED FUNCTION UNPAIRED FUNCTION

6 3
LARYNX articulate with
the superior
Largest
border
Known as shield-
Arytenoid on the posterior Thyroid cartilage
shaped piece
of the cricoid
**adam’s apple
cartilage

attached to the
superior tips of
Corniculate Cricoid cartilage
the arytenoid Base
cartilages.

Unique; freely
movable flap
made of elastic
contained in a
cartilage instead
mucous
of hyaline.
membrane
Cuneiform Epiglottis
anterior to the
***It helps divert
corniculate
food away from
cartilages
the trachea
opening during
swallowing.
 PAIRED FUNCTION UNPAIRED FUNCTION

6 3

LARYNX articulate with

the superior Largest
border Known as
on the Thyroid shield-shaped
Arytenoid
posterior of cartilage piece
the cricoid **adam’s
cartilage apple

attached to
the superior
Cricoid
Corniculate tips of
cartilage Base
the arytenoid
cartilages.

Unique; freely
movable flap
made of
elastic
cartilage
contained in a
instead of
mucous
hyaline.
membrane
Cuneiform Epiglottis
anterior to the
***It helps
corniculate
divert
cartilages
food away
from the
trachea
opening during
swallowing.
Lower respiratory tract:
Trachea

Tracheal rings?

Trachealis
muscle?
 PAIRED FUNCTION UNPAIRED FUNCTION

6 3

LARYNX articulate with

the superior Largest
border Known as
on the Thyroid shield-shaped
Arytenoid
posterior of cartilage piece
the cricoid **adam’s
cartilage apple

attached to
the superior
Cricoid
Corniculate tips of
cartilage Base
the arytenoid
cartilages.

Unique; freely
movable flap
made of
elastic
cartilage
contained in a
instead of
mucous
hyaline.
membrane
Cuneiform Epiglottis
anterior to the
***It helps
corniculate
divert
cartilages
food away
from the
trachea
opening during
swallowing.
Lower respiratory tract:
Bronchi
Carina?

Trachealis
muscle?
 consists of the trachea and the network of air tubes in the lungs.

TRACHEOBRONCHIAL TREE Divides up to 23 generations from the primary bronchi.

(a) The conducting zone of the tracheobronchial tree begins at the trachea and ends at the
terminal bronchioles. (b) A bronchogram is a radiograph of the tracheobronchial tree.
A contrast medium, which makes the passageways visible, is injected through a catheter after a
topical anesthetic is applied to the mucous membranes of the nose, pharynx, larynx, and
trachea
 TRACHEOBRONCHIAL TREE

The right main bronchus is larger in diameter and more directly in line with the
trachea than the left main bronchus.
Because the right main bronchus is more in line with the trachea, an inspired
object is more likely to become lodged in it than in the left main bronchus.

The main bronchi have cartilage rings like those in the trachea. Within each
lung, there are four main classes of air passageways. Overall, approximately
16 generations of branching occur from the trachea to the smallest air tubes.
TRACHEOBRONCHIAL TREE

1 – TRACHEA
2 – CARINA
3 – PRIMARY/MAIN BRONCHI
4 – LOBAR/SECONDARY BRONCHI
5 – SEGMENTAL BRONCHI/TERTIARY BRONCHI
6 – BRONCHIOLES
7 – TERMINAL BRONCHIOLES
ALVEOLI

The sites of pulmonary respiration.

-- are small, airfilled chambers where the air and the blood
come into close contact with each other.

From the terminal bronchioles to the alveoli, there are

approximately seven generations of branching.
In order from largest to smallest these branches are:

1- Respiratory bronchioles
2- Alveolar duct
3- Alveolar sacs
ALVEOLI

The sites of pulmonary respiration.

-- are small, airfilled chambers where the air and the blood
come into close contact with each other.

From the terminal bronchioles to the alveoli, there are

approximately seven generations of branching.
In order from largest to smallest these branches are:

1- Respiratory bronchioles
2- Alveolar duct
3- Alveolar sacs
Alveolus and the Respiratory Membrane

Two types of cells form the

alveolar wall:
(1)type I pneumocytes
(2) type II pneumocytes
Type I pneumocytes arethinsquamousepithelialcellsthatform
90%of thealveolarsurface.Mostofthegasexchangebetween
alveolarairandthebloodtakesplacethroughthesecells.
Type II pneumocytes areroundorcube-shapedsecretorycells
thatproduce surfactant,which makes it easierforthe alveoli to
expand duringinspiration.
Alveolus and the
Respiratory
Membrane
The alveolar walls and surrounding pulmonary capillaries form the
respiratory membrane in the lungs. It is the location ofpulmonary
respiration.
In other words, it is where O2 enters the blood and CO2 exits the
blood.

The general respiratory membrane components are the following:

1. The alveolar cell layer
2. The capillary endothelial layer
3. An interstitial space between the alveolar layer
and the capillary layer
Flow of Air in the Respiratory system

AIR Nose/Mouth Pharynx Larynx

Secondary
Primary Bronchi Trachea
Bronchi

Tertiary Bronchi Bronchioles Terminal

Bronchioles

Respiratory
Alveolar Sacs Alveolar Ducts
Bronchioles
Gross Anatomy of the Lungs

o The lungs are the principal organs

of respiration.
o Conical in shape, with the base
resting on the diaphragm.
o The hilum is the point where the
blood vessels and the primary
bronchi enter the lungs.
 Right vs Left Lungs

Comparison of the Right and Left Lungs

Right Lung Left Lung
• Larger • Smaller
• Has three lobes • Has 2 lobes
• Divided by 2 fissure • Divided by 1 fissure
• (+) Lingula and cardiac
notch
Bronchopulmonary segments

o Separated from one another by connective

tissue septa.
o Has its own artery, vein, and individual
segmental bronchi.
o Affectation/pathology of one segment spares
the other segment.

o Right Lungs: 10 segments

o Left Lungs: 9 segments

o Naming: Segment + laterality + Lobe of the

lung
Effect of the Respiratory
Muscles on Thoracic
Volume
Inspiration
o
o
The movement of air inside the lungs.
During quiet inspiration, the thorax Expiration
expands to increase the capacity of the
lungs. ⤜ Movement of air outside of the lungs
o Mechanisms of thorax expansion: ⤜ QUIET expiration is largely a
1. Upward and downward
movement of the diaphragm PASSIVE phenomenon.
(piston pump mechanism)
2. Elevation and depression of ⤜ FORCED expiration as an ACTIVE
the ribs and sternum (pump process brought about by forceful
handle mechanism)
3. Elevation and depression of contraction of the muscles of the
the ribs (bucket-handle abdominal wall.
mechanism)
o During forceful inspiration, every
muscle that can elevate the ribs is
brought into action and the thorax
maximally expands.
Pump Handle
Mechanism
MUSCLES OF RESPIRATION

Muscles of Respiration
Quiet Inspiration Forced Forced Expiration
Inspiration
Diaphragm External intercostal Internal intercostal,
Serratus posterior interosseous portion
superior Innermost intercostal
Erector spinae Transversus thoracis
Sternocleidomastoid Subcostal muscle
Scalenus anterior, Serratus posterior
medius, and posterior inferior
Pectoralis major Transversus
Pectoralis minor abdominis
Internal oblique
External oblique
Rectus abdominis
Respiratory Structures in the
Brainstem
Respiratory Structures MEDULLARY
in the Brainstem RESPIRATORY CENTER
2 NEURONS
1. DRG – most active during inspiration.
- stimulates contraction of diaphragm
1. VRG – active in both inspiration and
expiration.
- primarily stimulates the external and internal
intercostals and abdominal muscles

PONTINE RESPIRATORY
GROUP/pneumotaxic
center
-helps regulaterespiration rate
-appears toplayarolein switchingbetween inspiration and expiration,
thus fine-tuningthebreathingpattern
PRESSURE GRADIENT AND AIRFLOW

During inspiration, air flows into the lungs down its pressure
gradient. During expiration, air flows out of the lungs down its
pressure gradient.

This pressure gradient is provided, in part, by atmospheric pressure—the combined force of all the
gases that make up the air we breathe. The physics of airflow in tubes, such as the ones that make up
the respiratory passages, is the same as that of the flow of blood in blood vessels

Air moves through tubes because of a pressure difference:

Air moves from areas of higher pressure to areas of lower pressure.

For example, during inspiration, air pressure outside the body is greater than air pressure in the
alveoli, and air flows into the body through the trachea and bronchi to the alveoli.
PRESSURE GRADIENT AND AIRFLOW

PRESSURES THAT CAUSE MOVEMENT OF AIR IN AND OUT OF THE LUNGS

1. Pleural pressure
2. Alveolarpressure
Pleural pressure is the pressure of the fluid in the thin space between the lung pleura and
chest wall pleura.
This pressure is normally a slight suction, which means a slightly negative pressure. The
normal pleural pressure at the beginning of inspiration is about −5 centimeters of water (cm H2O),
which is the amount of suction required to hold the lungs open to their resting level. During normal
inspiration, expansion of the chest cage pulls outward on the lungs with greater force and
creates more negative pressure to an average of about −7.5 cm H2O.
Alveolar pressure - is equal to atmospheric pressure, which is considered to be zero reference
pressure in the airways—that is, 0 cm H2O pressure. To cause inward flow of air into the alveoli
during inspiration,the pressure in the alveoli must fall to a value slightly below atmospheric
pressure (below 0).
END OF LECTURE